Training, Case Management & Ops Sop Governance, Analyst

AIA Group

Kuala Lumpur, Malaysia
Medical health settlement authorization
Handle complex policy cases
Fraud, waste and abuse identification
Responsible for determining operational excellence and customer satisfaction by empowering assessors through continuous training, reducing operational costs, ensuring consistent in validity and authorizing settlement of medical health

Job Summary

  • Responsible for determining operational excellence and customer satisfaction by empowering assessors through continuous training, reducing operational costs, ensuring consistent in validity and authorizing settlement of medical health.
  • Responsible for handling complex policy cases which require special investigative skills or significant involvement and collaboration from different stakeholders to follow through together with MOH directives while fostering a culture of compliance, efficiency, and integrity.
  • Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.

Matching Summary

Responsible for determining operational excellence and customer satisfaction by empowering assessors through continuous training, reducing operational costs, ensuring consistent in validity and authorizing settlement of medical health.

Skills & Requirements

Must-have

  • Medical health settlement authorization
  • Handle complex policy cases
  • Fraud, Waste and Abuse identification
  • Claims adjudication according to charges
  • Process improvement strategies
  • Medical Advisory for claims team

Nice-to-have

  • Shaping a healthier future
  • Inspiring and supportive leaders
  • Customer satisfaction focus
  • Culture of compliance and integrity

Key Requirements

  • Bachelor’s degree in health sciences or equivalent
  • Minimum 5 years in health claims management
  • Prior audit or quality assurance experience
  • Industry-related medical or healthcare certification
  • Strong analytical and audit skills
  • Knowledge of insurance claims adjudication
  • Excellent communication and stakeholder management

Work Rights

Not specified

Tailored Resume

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